Asthma is a chronic airway hyperresponsiveness (with acute exacerbations), which is widespread all over the world in both children and adults. In most cases, it is in response to environmental stimuli. The main pathological changes are bronchospasm, edema and mucosal plugging, and the symptoms are wheezing, cough and breathlessness. Asthma therapy is directed against bronchospasms or inhibition of inflammation in general or their mediators such as leukotrienes. The most common drugs used are inhaled β2 agonists and inhaled corticosteroids.

00:01
Next, we want to talk about the leukotriene antagonists.
Now these drugs are not as effective as inhaled steroids.
00:07
Remember the steroids have a multimodal activity whereas
leukotriene antagonists are actually fairly specific.
00:14
They are not recommended for acute asthmatic events.
00:17
They are very very effective in
exercise induced bronchospasm and bronchoconstriction.
00:23
And they can be used in antigen induced bronchospasm.
They can also be used in aspirin allergy.
00:31
Remember that in aspirin allergy,
eicosanoid production is directed towards the leukotrienesso LTAs are very very active at that point.
00:41
Aspirin induced bronchospasm is not commonly seen
and you may not see very many patients with it,however it is something that shows up on exams every now and then
so it is a disease that I want you to be aware of.
00:55
So typically, the exam question will talk about a patient
being put on aspirin and then developing asthma symptoms.
01:01
So keep your eye open for that.
01:04
Okay. These are the names of the agents
that are in the LTA category.
01:12
Let's move on to toxicity.
Generally the toxicity is quite low with the LTAs.
01:18
Churg-Stauss vasculitis is also
a quite rare complication of this medication.
01:23
And you can sometimes get an occasional elevation of
liver enzymes. This is more common with zileuton.
01:29
The receptor blockers cause less elevation than zileuton
and that should be noted.

About the Lecture

The lecture Leukotriene Receptor Antagonists by Pravin Shukle, MD is from the course Respiratory Pharmacology.

Included Quiz Questions

A 34-year-old male is rushed to the Emergency Department with severe tachypnea. While gasping for air he reports that he is having an asthmatic attack but forgot his inhaler at home. Which of the following medications would NOT be suitable to treat this acute exacerbation?

Leukotriene antagonists.

Short acting beta agonists.

Long acting beta agonists.

Corticosteroids.

Methylxanthine.

Author of lecture Leukotriene Receptor Antagonists

Pravin Shukle, MD

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